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<br />r <br /> <br />.' <br /> <br />INSTRUCTIONS: <br />(I) If tlse lUm is claimed by a firm or corporation, state hue that affiant is a member of the firm or his <br />oifidai t>1FJei1y... the corp~. <br />(1}'Sltrtt,-lswlT':1JIuIthw 'fl"bal or writtinl contrtu:t. If written, attach copy, or lien is void. <br />(3) "$TeeJWn,>> "ColUtNICtilm," "AltllTation," or "Repair," as the CtUIJ may be. <br />(4) H&t"t! Uu"' correct lefJfJl descrip/iq.. of fand. <br />(5) If the labor tmd ~ were fNmisil8d the contractor and flat the oWfter direct, slate "thaL___......... <br />was. the co..mutor 0.. :,aid. build.au aM acting faT ti18 O"l1J1UT." <br />(6}>JJ~luu iHlm gW,ta,my "soida1lliOW1llisflWt'-~edby a prqmUsory1tOte,acopyufsoid notlT <br />.bei#g Mretoatt<<1t#4tmdmarked 'Exhibit B'." <br /> <br /> <br />1 "1~J II <br />~ <<= .~ <br />~ r'W\~ .' ... I ...... <br /> .< <br />::l ....' ..,~- S -.1 <br />8 Q';) .!1 'I '" v <br /> . ., ~, <br /> 1-1'''-.1 x: -li,-, <br /> . .. "'. 11l':., - \"l - <br />;; ... ~" Jr."'- ..q; <br /> , "'..""%~"":'. ~..J !~ <br />-g :.- .-'- ~-4._ - ... <br /> .....- ~ <br />... .. <br />41 (Y) C -' ~.~ .... <br />c :X) w $iJ \:!: ""' <br />,.,. "'" <br />JJ ~ ;::, ~ <br /> t- ... ..... ..~ <br /> ... .. - <br /> .. <br /> <br />., ~ <br />I' ~ <br />\"',~.~ ~ <br />'~.~..... <br />~"~. 'f <br />,j "\\X <br />"'-"'.... ~ .;) <br />~".jl' <br />"-\ ,:j <br />v". \\ <br />J " I C'\ <br />';,1 '.<S ~, <br />\';:, rV'~ "-.J <br />~~~ \j, <br /> <br />